Provider Demographics
NPI:1760816516
Name:OSTRANDER, LINDA LEIGH (MA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LEIGH
Last Name:OSTRANDER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1399 BELCHER RD S
Mailing Address - Street 2:LOT 143
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-5237
Mailing Address - Country:US
Mailing Address - Phone:727-824-5745
Mailing Address - Fax:727-898-2407
Practice Address - Street 1:445 31ST ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7605
Practice Address - Country:US
Practice Address - Phone:727-824-5745
Practice Address - Fax:727-898-2407
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004586101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health